Individual
DR. CORY SCOTT BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
775 POLE LINE RD W, SUITE 301, TWIN FALLS, ID 83301-5814
(208) 814-8700
(208) 933-4914
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
M11288
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629256573
—
ID
01
—
P00983737
MCRR
ID
Enumeration date
02/02/2008
Last updated
12/30/2014
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